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DOI: 10.1055/a-2542-9930
Recompensation in Cirrhosis: Biomarkers and Strategies
Financial Support and Sponsorship This work was supported by FIS 23/00997, funded by “Instituto de Salud Carlos III” and co-funded by the European Union. From “CIBEREHD” funded by “Instituto de Salud Carlos III.” From the “Commissioner for Universities and Research from the Department of Economy and Knowledge” of the “Generalitat de Catalunya” (AGAUR SGR2021 01115). S.S. has a Rio Hortega Grant. The current contract is funded by “Instituto de Salud Carlos III” with charges to the European funds of the Recovery, Transformation, and Resilience Plan (Plan de Recuperación, Transformación y Resiliencia), with files code CM23/00068, according to the Resolution of the Instituto de Salud Carlos III, O.A., M.P. of December 2023, granting the Rio Hortega Contracts, and “Co-Financed by the European Union.” EAT has a “Juan Rodés Post-Doctoral Grant” funded by “Instituto de Salud Carlos III” with file code (JR20/00047), and the PI21/01995 funded by “Instituto de Salud Carlos III” and co-funded by the European Union. We also thank the CERCA Program/Generalitat de Catalunya.

Abstract
The onset of decompensation in advanced chronic liver disease (ACLD) is a hallmark in natural history, with a poor prognosis and a significantly increased liver-related mortality. Etiological treatments for viral hepatitis or abstinence in cirrhosis due to alcohol abuse have demonstrated that some patients experience partial to complete clinical and analytical improvement, a stage termed “recompensation.” Although recompensation is primarily defined clinically based on treatable etiologies, it is still evolving for conditions like metabolic dysfunction-associated steatotic liver disease (MASLD). Despite the need for specific biomarkers in hepatic recompensation, no biomarkers have been thoroughly studied in this context. Biomarkers identified in compensated ACLD (cACLD) following etiological treatment might be explored for recompensation. Although the pathophysiology mechanisms underlying the hepatic recompensation remain unclear, understanding the mechanism involved in cirrhosis decompensation could help identify potential targets for recompensation. This review provides an update on the hepatic recompensation concept, examines the existing data on invasive and non-invasive biomarkers, mainly in cACLD after cure, that could be raised in recompensation, and explores future therapeutic targets for the hepatic recompensation process.
* Shared first author.
# Shared corresponding author.
Publication History
Article published online:
03 April 2025
© 2025. Thieme. All rights reserved.
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